LAUSR

Caustic ingestion is an uncommon but potentially life-threatening condition. It can lead to various complications. There are limited epidemiological studies on caustic ingestion, especially in the Asian population. This study aims to review the clinical characteristics of corrosive ingestion in Hong Kong adults and look for predictors of adverse clinical events. Patients admitted for caustic ingestion at a tertiary referral center in Hong Kong between January 2001 and December 2021 were studied. Patients’ demographic and clinical characteristics, types of caustic substances ingested, Zargar endoscopic grading and clinical outcomes were obtained. Adverse clinical events are defined as the presence of any of the following outcomes: intensive-care-unit (ICU) admission, gastrointestinal (GI) complications (including stricture, ischemia, gangrene, perforation and fistulation), need for surgical or endoscopic intervention, in-hospital mortality, or length of hospital stay (LOS) more than 14 days. Relationships between patients’ factors and different outcomes were then evaluated. Among 69 patients, 45 (65.2%) were suicidal intent. Eight (11.6%) patients required emergency surgery (7 gastrectomies, and 1 esophagectomy). The most common GI complication was esophageal stricture (n=12, 17.4%). Eleven patients underwent endoscopic dilatation; 4 required elective esophagectomy. Patients with diabetes mellitus had a higher Zargar grading (OR=4.259, p=0.040). Adverse clinical events were associated with acid ingestion (OR=4.110, p=0.015) and suicidal intent (OR=3.635, p=0.027). Subgroup analysis showed that diabetes (OR=4.062, p=0.040), acid ingestion (OR=4.222, p=0.016) and suicidal intent (OR=15.932, p=0.009) had higher risks for ICU admission. The morbidity and mortality rates were 29.0% and 7.2% respectively. Caustic ingestion remains an important clinical problem in daily practice, with potential risks of developing severe complications. Suicidal attempt, acid ingestions and history of diabetes are predictors of adverse clinical events.